Evidence map›Paper›PMID 40132614›Full record

ArticleJournal of inherited metabolic disease2025

Increased Survival in Patients With Molybdenum Cofactor Deficiency Type A Treated With Cyclic Pyranopterin Monophosphate.

Guenter Schwarz, Donald G Basel, Bernd C Schwahn, Ronen Spiegel, Flora Y Wong, Robin Bliss, Liza Squires

Abstract read
In one paragraph

Article in Journal of inherited metabolic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Guenter SchwarzDepartment of Chemistry and Biochemistry and Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.ORCID 0000-0002-2118-9338
Donald G BaselDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Bernd C SchwahnManchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, UK.
Ronen SpiegelDepartment of Pediatrics B, Emek Medical Center, Afula, Rappaport Faculty of Medicine, Haifa, Israel.
Flora Y WongDepartment of Pediatrics, Monash University; Monash Newborn, Monash Children's Hospital, Melbourne, Australia.
Robin BlissVeristat, Southborough, Massachusetts, USA.
Liza SquiresSentynl Therapeutics, Solana Beach, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Molybdenum cofactor deficiency (MoCD) Type A is an ultrarare disorder causing neurodegeneration and early death. Cyclic pyranopterin monophosphate (cPMP), a molybdenum cofactor precursor, is a therapeutic option for patients with MoCD Type A. In this study, efficacy in patients with MoCD Type A treated with recombinant cPMP (rcPMP) and/or fosdenopterin, a synthetic form of cPMP, from one retrospective and two prospective open-label studies (N = 14), was compared with a retrospective/prospective natural history study (untreated; N = 37). Safety was evaluated in treated patients. Patients treated with fosdenopterin/rcPMP had significantly reduced risk of premature/early death versus untreated patients (Cox proportional hazards 5.1; 95% CI 1.32-19.36; p = 0.01). MoCD disease biomarkers of urinary S-sulfocysteine and xanthine returned to near-normal from baseline to last visit in treated patients but remained abnormal in untreated patients. At 12 months, in treated patients, 43% could sit unassisted, 44% were ambulatory, and 57% could feed orally. Initiating fosdenopterin/rcPMP treatment ≤ 14 days after birth appeared to result in better clinical outcomes than initiating > 14 days after birth. Most patients (13/14) had a treatment-emergent adverse event; most were unrelated to fosdenopterin/rcPMP, were mild to moderate in severity, and none led to treatment discontinuation. These results demonstrate that patients with MoCD Type A who received fosdenopterin/rcPMP versus untreated patients were more likely to survive. Some treated patients were able to feed orally and achieve developmental milestones including walking. Fosdenopterin/rcPMP was generally well-tolerated. Improved outcomes in patients treated early support the importance of identifying MoCD in neonates and initiating treatment as soon as possible.

Indexed as

Metal Metabolism, Inborn ErrorsPteridinesPterinsAdolescentBiomarkersChildChild, PreschoolFemaleHumansInfantMaleOrganophosphorus CompoundsProspective StudiesRetrospective StudiesTreatment OutcomeBiomarkersnulibryOrganophosphorus CompoundsPteridinesPterinscPMPcyclic pyranopterin monophosphatefosdenopterinMoCD Type Amolybdenum cofactor deficiency

Identifiers

PMID40132614
PMCPMC11936520

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.